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GENICULAR NERVE ABLATION IN KNEE OSTEOARTHRITIS: A RANDOMIZED PROSPECTIVE STUDY.

João Vital Arthur Maradona Oliveira Dias1, Vitor Ricardo Alves Pereira de Moraes1, Matheus Trindade Bruxelas de Freitas1

  • 1Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas, Instituto de Ortopedia e Traumatologia (HC-FMUSP), São Paulo, SP, Brazil.

Acta Ortopedica Brasileira
|August 21, 2025
PubMed
Summary

Genicular nerve ablation offers lasting pain relief and improved function for severe knee osteoarthritis patients. Both pulsed radiofrequency and phenol ablation methods are equally effective in enhancing quality of life.

Keywords:
Osteoarthritis, KneePainPhenolRadiofrequency Ablation

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Area of Science:

  • Orthopedics
  • Pain Management
  • Regenerative Medicine

Background:

  • Severe knee osteoarthritis (OAJ) significantly impacts patient function and quality of life.
  • Genicular nerve ablation is an emerging treatment option for managing refractory knee pain.
  • Comparing pulsed radiofrequency (PRF) and phenol ablation for genicular nerve treatment is crucial.

Purpose of the Study:

  • To evaluate the efficacy of genicular nerve ablation in patients with severe knee osteoarthritis (OAJ).
  • To compare the outcomes of pulsed radiofrequency (PRF) versus phenol ablation for genicular nerve treatment.
  • To assess pain reduction and functional improvements at 1 and 3 months post-procedure.

Main Methods:

  • A prospective, randomized, controlled trial involving 35 patients with grade IV knee osteoarthritis.
  • Patients underwent genicular nerve ablation using either PRF or phenol.
  • Outcomes measured included pain (NRS), function (KOOS, TSL30), and mobility (TUG) at baseline, 1, and 3 months.

Main Results:

  • Both PRF and phenol ablation groups showed significant, comparable improvements in pain and function up to 3 months.
  • Numeric Rating Scale (NRS) pain scores decreased by an average of 30% in both groups.
  • Timed Up and Go (TUG) test performance improved, and 30-Second Chair Stand Test (TSL30) performance increased, indicating better function.

Conclusions:

  • Genicular nerve ablation, using either PRF or phenol, provides significant and lasting improvements for severe knee osteoarthritis.
  • Both ablation techniques demonstrated comparable effectiveness in enhancing pain relief, function, and quality of life.
  • This study provides Level I evidence supporting genicular nerve ablation as a viable treatment for severe OAJ.